Improved identification of cranial nerves using paired-agent imaging: topical staining protocol optimization through experimentation and simulation

Veronica C. Torres; Todd Wilson; Austeja Staneviciute; Richard W. Byrne; Kenneth M. Tichauer

doi:10.1117/12.2285206

1 March 2018 Improved identification of cranial nerves using paired-agent imaging: topical staining protocol optimization through experimentation and simulation

Veronica C. Torres, Todd Wilson, Austeja Staneviciute, Richard W. Byrne, Kenneth M. Tichauer

Author Affiliations +

Proceedings Volume 10478, Molecular-Guided Surgery: Molecules, Devices, and Applications IV; 104780I (2018) https://doi.org/10.1117/12.2285206
Event: SPIE BiOS, 2018, San Francisco, California, United States

Abstract

Skull base tumors are particularly difficult to visualize and access for surgeons because of the crowded environment and close proximity of vital structures, such as cranial nerves. As a result, accidental nerve damage is a significant concern and the likelihood of tumor recurrence is increased because of more conservative resections that attempt to avoid injuring these structures. In this study, a paired-agent imaging method with direct administration of fluorophores is applied to enhance cranial nerve identification. Here, a control imaging agent (ICG) accounts for non-specific uptake of the nerve-targeting agent (Oxazine 4), and ratiometric data analysis is employed to approximate binding potential (BP, a surrogate of targeted biomolecule concentration). For clinical relevance, animal experiments and simulations were conducted to identify parameters for an optimized stain and rinse protocol using the developed paired-agent method. Numerical methods were used to model the diffusive and kinetic behavior of the imaging agents in tissue, and simulation results revealed that there are various combinations of stain time and rinse number that provide improved contrast of cranial nerves, as suggested by optimal measures of BP and contrast-to-noise ratio.

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Veronica C. Torres, Todd Wilson, Austeja Staneviciute, Richard W. Byrne, and Kenneth M. Tichauer "Improved identification of cranial nerves using paired-agent imaging: topical staining protocol optimization through experimentation and simulation ", Proc. SPIE 10478, Molecular-Guided Surgery: Molecules, Devices, and Applications IV, 104780I (1 March 2018); https://doi.org/10.1117/12.2285206

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